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Current Psychiatry Reports

, 21:113 | Cite as

Acute and Transient Psychotic Disorders: Newer Understanding

  • Savita MalhotraEmail author
  • Swapnajeet Sahoo
  • Srinivas Balachander
Schizophrenia and Other Psychotic Disorders (AK Pandurangi, Section Editor)
  • 48 Downloads
Part of the following topical collections:
  1. Topical Collection on Schizophrenia and Other Psychotic Disorders

Abstract

Purpose of Review

We review the ongoing research in the area of acute and transient psychotic disorders (ATPDs) with regard to their nosology, epidemiology, clinical description, genetics, and neurobiology, examining evidence for distinctiveness or otherwise of ATPDs. We further highlight the lacuna in research in ATPDs.

Recent Findings

Studies on ATPDs as defined in the ICD 10 have been reported from different parts of the world, more so from the developing countries. There is consistent evidence that there exist a group of ATPDs that occur more commonly among females, are often precipitated by stressful life events or exposure to physiological stresses like fever, child birth, are associated with well-adjusted premorbid personality, and show complete recovery in a short period. Although in some cases of ATPDs, there is symptomatic overlap with schizophrenic symptoms in the acute phase, they follow a completely different course and outcome, exhibit genetic distinctiveness, and do not share genetic relationship with schizophrenias or bipolar affective disorder (BPAD). Comparative studies on neurophysiology and neuroimaging in ATPDs and schizophrenias have demonstrated evidence of hyper arousal and hyper metabolism in ATPDs vs hypo arousal and hypo metabolism as noted in the P300 response and on FDG PET studies, respectively. Immune markers such as IL-6, TNF-alpha, and TGF-beta show higher levels in ATPDs as compared to healthy controls. Findings on the neurobiological mechanisms underlying ATPDs, so far, point towards significant differences from those in schizophrenia or BPAD. Although the studies are few and far between, nevertheless, these point towards the possibility of ATPDs as a distinct entity and underscore the need for pursuing alternate hypothesis such as neuro inflammatory or metabolic.

Summary

Research on ATPDs is limited due to many reasons including lack of harmony between the ICD and DSM diagnostic systems and clinician biases. Available research data supports the validity of ATPDs as a distinct clinical entity. There is also evidence that ATPDs are different from schizophrenias or BPAD on genetic, neuroimaging, neurophysiological, and immunological markers and require further studies.

Keywords

Acute and transient psychotic disorders Biological studies Nosology Schizophrenias Validity Genetics Neuroimaging studies 

Notes

Compliance with Ethics Guidelines

Conflict of Interest

Savita Malhotra, Swapnajeet Sahoo, and Srinivas Balachander each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Savita Malhotra
    • 1
    Email author
  • Swapnajeet Sahoo
    • 2
  • Srinivas Balachander
    • 3
  1. 1.Fortis HospitalMohaliIndia
  2. 2.Department of PsychiatryPostgraduate Institute of Medical Education & Research (PGIMER)ChandigarhIndia
  3. 3.Department of PsychiatryNational Institute of Mental Health & Neurosciences (NIMHANS)BengaluruIndia

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